The experience of co-morbidity: an interpretative phenomenological analysis: living with chronic pain and traumatic stress

There are few qualitative studies exploring co-morbidity and specifically the experience of living with chronic pain and traumatic stress. In addition existing research has focused on the relationship between chronic pain and post-traumatic stress disorder (PTSD) but has not considered the impact of complex post-traumatic stress disorder (CTPSD) on co-existing chronic pain.
The aim of this study was to explore the individual’s unique experience of living with co-morbid chronic pain and traumatic stress. This study also supports a wider formulation by exploring CPTSD as a construct, acknowledging the diversity of symptoms beyond the diagnostic criteria of PTSD. Five participants were interviewed about their experiences. Interpretative phenomenological analysis (IPA) was used to analyse the data.
An IPA analysis revealed six superordinate themes: 1) “Every day is just such a struggle”; 2) Isolation; 3) The relationship between chronic pain and traumatic stress; 4) Chronic pain and traumatic stress change the relationship with the self; 5) Ways of coping with chronic pain and traumatic stress; 6) Moving forward; learning to adjust and live with chronic pain and traumatic stress.
The super-ordinate themes highlight the everyday reality of living with this co-morbidity, suggesting that co-morbid chronic pain and traumatic stress do not exist as separate isolated symptoms but are impacted by individual, relational and social factors. The results also highlight the complex interrelationship between chronic pain and traumatic stress.
Implications for policy and clinical practice include raising awareness and providing access to effective care pathways for clients who live with this distressing co-occurrence. An integrated treatment approach is required to address the meaning and multi-dimensional nature of living with this co-morbidity. Recommendations are made for further research in this area.